This invention relates to a surgical retention system and, in particular, to apparatus for providing a uniform, evenly distributed, ligation to an incision to prevent the closure sutures from breaking and the wound from rupturing.
The most pertinent prior art known to the applicant at the time of filing this application can be found in U.S. Pat. Nos. 3,648,705 to Lary; 3,695,271 to Chodrow; 3,789,851 to LaVeen.
Relatively heavy retention sutures have been used for some time to reinforce lighter closure sutures located at the wound face and thus safeguard the incision against possible disruption as it heals. In many applications, the retention loop is passed laterally over the incision and anchored tautly below the skin on either side thereof. The sutures, in this arrangement, tend to elongate and erode into the skin at the wound face as well as causing skin necrosis and excessive scarring.
In an effort to overcome some of the noted difficulties, the retention sutures are sometimes passed over gauze pads or through rubber tubes to prevent them from being drawn directly into contact with the wound. Similarly, plastic bridges, such as those disclosed in some of the previously noted patents, have been devised which span the incision and provide a platform against which the retention sutures can act. All these prior art devices, however, require that the retention suture pass back and forth over the wound and thus prevent free access to the wound area which makes dressing or treating of the wound difficult. Furthermore, most of the bridges presently available are relatively unstable and can be easily toppled when bumped or if subjected to excessive body movement causing the entire system to fail.
Simple buttons have been used with some effectiveness as anchor points in some retention systems. The buttons are aligned on either side of the incision and suture loops passed between the buttons. Typically, two buttons on either side of the incision are joined together by means of a single loop. The two buttons are, in practice, drawn tightly against the skin when the ends of the suture loop are tied off. It has been found that retention forces in this type of system can become localized in and around the concentrated button hole region and produce excessive skin irritation and damage. The buttons, as well as many other prior art retention devices, also prevent natural perspiration from occurring thereby causing further skin irritation problems.
It is an object of the present invention to improve surgical retention systems for use in closing an incision.
A further object of the present invention is to promote healing of a surgically induced incision and thus promote greater use of this system.
Yet another object of the present invention is to minimize the extent of skin damage and irritation produced by a retention suture.
A still further object of the present invention is to provide a retention suture system which affords complete freedom of access to the retained incision.
Another object of the present invention is to distribute the holding forces of an incision retention system uniformly over a wide area to avoid the production of high localized skin pressures.
A further object of the invention is to provide a retention system employing one or more pairs of retaining bars which will allow for perspiration in the skin contact region.
A still further object of the present invention is to provide a retention suture system that is easy to implant and remove.
These and other objects of the present invention are attained by means of a retention system for maintaining closure of a surgical incision and includes at least one pair of elongated retaining bars that are of similar design and construction. Each bar consists of a relatively rigid upper plate having a complimentary sponge-like pad affixed to its bottom surface that is adapted to conform to the contour of the body. One or more pairs of suture holes are located along the longitudinal axis of the bar with the spacing between holes being substantially equal to the width of the pad at the skin contact surface. The bars are cojoined by means of retention suture loops that are embedded beneath the skin and which extend below the surface of the skin between corresponding holes in each of the bars.